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Pharmacy Coverage for UC Riverside

SHC
Outside the SHC
Student Health Pharmacy
Participating UC Pharmacies and other OptumRx Pharmacies
SEPARATE LIMITS ON YOUR OUT-OF-POCKET COSTS
Network Providers: $3,000/individual; $6,000/family
Out-of-Network Providers: $6,000/individual; $12,000 family
Your share of prescription drug costs counts toward the combined annual medical/pharmacy out-of-pocket limit listed above.
UC SHIP Covers

Outpatient Prescription Drugs

  • 100% after $5 generic copay
  • 100% after $25 brand-name formulary copay, 30-day supply
  • 100% after $50 brand name non-formulary copay, 30-day supply
  • 100% after $50 specialty copay, 30-day supply
  • $5 generic copay
  • $25 brand-name formulary copay, 30-day supply
  • $50 brand name non-formulary copay, 30-day supply
  • $50 specialty copay, 30-day supply

You pay any amount above OptumRx maximum allowed amount.

Note: 100% with no copay for FDA-approved generic and brand-name (when no generic equivalent is available). Oral contraceptives are covered for up to 180-day supply.